Objectives: The aim of this study was to investigate whether patients with schizophrenia are aware of the current status and have accurate information about COVID-19. Methods: The participants consisted of 161 inpatients and 117 outpatients with schizophrenia and 40 normal controls. The subjects completed self-report questionnaires measuring changes in their daily life, their perceptions of the current status of COVID-19 and their basic knowledge about the disease. Results: Compared to the normal control group, the inpatients and outpatients with schizophrenia underestimated the cumulative number of confirmed COVID-19 cases and overestimated the mortality rate of COVID-19. The mortality rates of COVID-19 and the common cold were higher in the order of inpatients, outpatients, and normal controls. The main route of SARS-CoV-2 infection and the main symptoms of COVID-19 were accurately recognized by more than 95% in the normal group and more than 80% in outpatients, but inpatients chose the correct answers at a lower rate. In the questions about misperceptions about COVID-19, the correct answer rate was high in the order of normal controls, outpatients, and inpatients. Most patients with schizophrenia obtained information about COVID-19 on TV, while most normal controls collected information through the internet. Conclusion This study showed that awareness of COVID-19 among patients with schizophrenia is insufficient. Additional measures are needed to provide accurate information and the current status of COVID-19 to patients with schizophrenia.

BACKGROUND: Several studies have revealed the frequency of family mealtimes to be inversely associated with depressive symptoms in adolescents. However, there have been few studies in older populations. This cross-sectional study investigated the association between family mealtime frequency and depressive symptoms in elderly Koreans. METHODS: This study analyzed 4,959 elderly men and women (aged 65 years or older) who participated in the Korea National Health and Nutrition Examination Survey. Self-administered questionnaires were used to assess depressive status, family mealtime frequency, and covariates. Multiple logistic regression analysis was performed to evaluate the association using the eating alone group as a reference. RESULTS: After adjusting for all covariates, participants who had family meals 3 times a day had fewer depressive symptoms than the eating alone group; adjusted odds ratios (ORs) (95% confidence intervals [CIs]) were 0.72 (0.58–0.89) for point depressiveness/anxiety and 0.73 (0.56–0.94) for depressiveness lasting for at least 2 weeks. In suicidal ideation, the OR (95% CI) of eating with family twice a day was significant after full adjusting for covariates at 0.67 (0.50–0.88). CONCLUSION: Family mealtimes were closely associated with depressive symptoms in elderly Koreans, which suggests that maintaining intrafamilial bonding is important for mental health in an older population.
Adolescent ; Aged* ; Asian Continental Ancestry Group ; Cross-Sectional Studies ; Depression* ; Eating ; Family Relations ; Female ; Humans ; Korea ; Logistic Models ; Male ; Meals* ; Mental Health ; Nutrition Surveys ; Odds Ratio ; Suicidal Ideation

Reelin, an extracellular glycoprotein has an important role in the proper migration and positioning of neurons during brain development. Lack of reelin causes not only disorganized lamination of the cerebral and cerebellar cortex but also malpositioning of mesencephalic dopaminergic (mDA) neurons. However, the accurate role of reelin in the migration and positioning of mDA neurons is not fully elucidated. In this study, reelin-deficient reeler mice exhibited a significant loss of mDA neurons in the substantia nigra pars compacta (SNc) and a severe alteration of cell distribution in the retrorubal field (RRF). This abnormality was also found in Dab1-deficinet, yotari mice. Stereological analysis revealed that total number of mDA neurons was not changed compared to wild type, suggesting that the loss of mDA neurons in reeler may not be due to the neurogenesis of mDA neurons. We also found that formation of PSA-NCAM-positive tangential nerve fibers rather than radial glial fibers was greatly reduced in the early developmental stage (E14.5) of reeler. These findings provide direct evidence that the alteration in distribution pattern of mDA neurons in the reeler mesencephalon mainly results from the defect of the lateral migration using tangential fibers as a scaffold.
Animals ; Brain ; Cerebellar Cortex ; Dopaminergic Neurons ; Glycoproteins ; Mesencephalon ; Mice ; Mice, Neurologic Mutants ; Nerve Fibers ; Neurogenesis ; Neurons ; Substantia Nigra

Objectives: Liraglutide is a glucagon-like-peptide-1 receptor agonist which has been used as an anti-obesity drug. It was reported that patients might develop or worsen suicidal ideas and/or depression during liraglutide treatment, especially when it comes to patients with a psychiatric disorder. The purpose of this study was to evaluate the effectiveness and safety of liraglutide, especially in terms of the psychiatric adverse effects. Methods: A retrospective chart review study was conducted on psychiatric patients prescribed liraglutide for more than one month from September 2018 to September 2020. Based on their medical records, we investigated the change in the weight and body mass index (BMI) of patients from the baseline to 6 months of receiving liraglutide treatment. Information on the adverse effects was also obtained, including psychiatric adverse effects such as insomnia, anxiety, depression, and suicidal ideation. A mixed linear model was used for assessing the time effect on change in weight and BMI. Results: A total of 24 patients were included in the current study, and the most common psychiatric diagnosis included major depressive disorder (n=13, 54.2%). There was a significant change in weight (F=6.127, p=0.001) and BMI (F=6.749, p<0.001) during the liraglutide treatment. Worsening of depression and anxiety occurred in one patient but improved after the adjustment of psychiatric medications. Conclusion The current study found that liraglutide treatment in patients with a psychiatric disorder can be a safe and effective intervention for weight reduction.

PURPOSE: This study was conducted to identify the effectiveness of a preoperative comprehensive geriatric assessment (CGA) for predicting postoperative morbidity in elderly patients who underwent surgery for colorectal cancer. METHODS: Elderly patients (≥70 years old) who underwent surgery for colorectal cancer at a tertiary hospital in Korea were identified, and their cases were analyzed using data from a prospectively collected database to establish an association between major postsurgical complications and 'high-risk' patient as defined by the CGA. RESULTS: A total of 240 patients, with a mean age of 76.7 ± 5.2 years, were enrolled. Ninety-five patients (39.6%) were classified as "high-risk" and 99 patients (41.3%) as having postoperative complications. The univariate analysis indicated that risk factors for postoperative complications were age, American Society of Anesthesiologists physical status classification, serum hemoglobin, carcinoembryonic antigen, cancer stage, and "high-risk" status. The multivariable analyses indicated that "high-risk" status (odds ratio, 2.107; 95% confidence interval, 1.168–3.804; P = 0.013) and elevated preoperative carcinoembryonic antigen (odds ratio, 2.561; 95% confidence interval, 1.346–4.871, P = 0.004) were independently associated with postoperative complications. A multivariable analysis of the individual CGA domains indicated that high comorbidities and low activities of daily living were significantly related with postoperative complications. CONCLUSION: A preoperative CGA indicating "high-risk" was associated with major postoperative complications in elderly patients who underwent surgery for colorectal cancer. Thus, using the CGA to identify elderly colorectal-cancer patients who should be given more care during postoperative management may be clinically beneficial.
Activities of Daily Living ; Aged* ; Carcinoembryonic Antigen ; Classification ; Colorectal Neoplasms* ; Comorbidity ; Geriatric Assessment* ; Humans ; Korea ; Postoperative Complications ; Prospective Studies ; Risk Factors ; Tertiary Care Centers

Typhoid fever, a serious systemic infection caused by Salmonella enterica serovar Typhi, breaks out in developing countries. However, existing vaccines only induce relatively low protective effects with humoral responses and do not stimulate secondary immune response, especially to young people. The objective of this study is to evaluate the immunogenicity of the vaccine containing virulence capsular polysaccharide (Vi) conjugated with the optimal ratios of non-toxic variant of diphtheria toxin (CRM(197)) in mice. Six-week-old BALB/c female mice were injected intraperitoneally three times at intervals of 14 days and sera were collected on days 0, 14, 28, 42 and 56 post-injection. The efficacy of the vaccine was evaluated by comparing between negative control group injected with PBS and vaccine groups injected with Vi or Vi-CRM(197) conjugate of different ratio. Vi and CRM(197)-specific antibody responses were evaluated using enzyme-linked immunosorbent assay. The result showed that Vi-CRM(197)-1 group revealed the highest and significant Vi-specific IgG immune responses among the other groups and Vi group (p < 0.01). In conclusion, Vi-CRM(197)-1 conjugate vaccine induced the highest humoral immune response in mice and may be used as an effective vaccine to replace the existing typhoid vaccine for infants under 2 years old.
Animals ; Antibody Formation ; Child, Preschool ; Developing Countries ; Diphtheria Toxin ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunity, Humoral ; Immunoglobulin G ; Infant ; Mice* ; Salmonella enterica* ; Salmonella typhi* ; Salmonella* ; Typhoid Fever ; Typhoid-Paratyphoid Vaccines ; Vaccines ; Virulence

PURPOSE: It is unknown whether patients with advanced rectal cancer develop severe constipation. Therefore, the objective of this study was to assess whether constipation severity is associated with pathologic progression of rectal cancer. METHODS: We analyzed 472 patients with rectal cancer who underwent elective surgical resection between January 2005 and December 2010. Constipation severity was prospectively evaluated in 407 patients (86.2%) using the Cleveland Clinic Constipation Score System. Linear regression analysis was performed to identify clinicopathologic variables associated with constipation. Kaplan-Meier analysis and Cox proportional hazard models were used to evaluate the prognostic value of constipation severity on disease-free and overall survival. RESULTS: Multivariable analysis showed that sex (regression coefficient [B] = 1.55; 95% confidence interval [CI], 0.79 to 2.60; P < 0.001), body mass index (B = -0.95; 95% CI, -1.83 to -0.64; P = 0.036), tumor size (B = 1.04; 95% CI, 0.20 to 1.88; P = 0.016), T stage (B = 0.75; 95% CI, 0.23 to 1.27; P = 0.005), and distant metastasis (B = 1.16; 95% CI, 0.03 to 2.30; P = 0.045) were associated with constipation severity. Severe constipation (score > or = 8) was independently associated with 3-year disease-free survival (vs. scores of 0-3; hazard ratio [HR], 2.39; 95% CI, 1.15 to 4.98; P = 0.020) and 5-year overall survival (HR, 2.30; 95% CI, 1.23 to 4.30; P = 0.009) in multivariable analysis. CONCLUSION: Our results suggest that preoperative constipation severity is associated with advanced pathologic stage and poor oncologic outcomes in patients with rectal cancer.
Body Mass Index ; Cohort Studies ; Constipation ; Disease-Free Survival ; Humans ; Kaplan-Meier Estimate ; Linear Models ; Neoplasm Metastasis ; Prognosis ; Proportional Hazards Models ; Prospective Studies ; Surveys and Questionnaires ; Rectal Neoplasms

BACKGROUND: A disputed rpoB mutation is a specific type of rpoB mutation that can cause low-level resistances to rifampin (RIF). Here, we aimed to assess the frequency and types of disputed rpoB mutations in Mycobacterium tuberculosis isolates from South Korea. METHODS: Between August 2009 and December 2015, 130 patients exhibited RIF resistance on the MTBDRplus assay at Asan Medical Center. Among these cases, we identified the strains with disputed rpoB mutation by rpoB sequencing analysis, as well as among the M. tuberculosis strains from the International Tuberculosis Research Center (ITRC). RESULTS: Among our cases, disputed rpoB mutations led to RIF resistance in at least 6.9% (9/130) of the strains that also exhibited RIF resistance on the MTBDRplus assay. Moreover, at the ITRC, sequencing of the rpoB gene of 170 strains with the rpoB mutation indicated that 23 strains (13.5%) had the disputed mutations. By combining the findings from the 32 strains from our center and the ITRC, we identified the type of disputed rpoB mutation as follows: CTG511CCG (L511P, n=8), GAC516TAC (D516Y, n=8), CTG533CCG (L533P, n=8), CAC526CTC (H526L, n=4), CAC526AAC (H526N, n=3), and ATG515GTG (M515V, n=1). CONCLUSION: Disputed rpoB mutations do not seem to be rare among the strains exhibiting RIF resistance in South Korea.
Biological Assay ; Chungcheongnam-do ; Humans ; Korea* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Rifampin ; Tuberculosis

Choledochal cyst has only rarely been encountered in association with pregnancy. The clinical manifestations are nonspecific and variable that makes it difficult to differentiate from physiologic changes in pregnancy. Consequently, diagnosis is often delayed until patients present with life-threatening complications. During pregnancy, symptoms of choledochal cyst may be developed by hormonal changes and the enlarged uterus. Because of the risk of fetal mortality and maternal morbidity, definitive surgical treatment should be delayed and step-by-step management should be carefully implemented to avoid complication until delivery. Herein, we report a case of enlarged, symptomatic choledochal cyst that developed in a 26-year-old pregnant woman. The temporal relationship between pregnancy and symptom development, as well as the biliary sludge formation in the enlarged cyst, suggest that the choledochal cyst was influenced by pregnancy. In order to buy time for fetal maturation, endoscopic ultrasonography-guided choledochoduodenostomy was performed for biliary decompression as a bridge to surgical excision.
Adult ; Bile ; Choledochal Cyst* ; Choledochostomy* ; Decompression ; Diagnosis ; Endosonography ; Female ; Fetal Mortality ; Humans ; Pregnancy* ; Pregnant Women ; Uterus

BACKGROUND: The aim of this study was to assess the feasibility of targeted ultrasound imaging on apoptosis with annexin A5 microbubbles (A5MB) in acute doxorubicin-induced cardiotoxicity. METHODS: Avidinated and octafluoropropan-filled phospholipid microbubbles were conjugated with biotinylated annexin A5. To confirm the specific binding of A5MB, flow cytometry was performed with hydrogen peroxide induced apoptosis in rat aorta smooth muscle cells incubated with fluorescein-5-isothiocyanate (FITC) labeled annexin A5 and A5MB. Adult male rats were injected intraperitoneally with 5 mg/kg doxorubicin weekly for 3 weeks (n = 5). Control rats were injected with normal saline (n = 5). At 24 hours after the final treatment, triggering imaging was performed 15 min after an intravenous bolus injection of A5MB for washout of freely circulating microbubbles. After echocardiography, the heart was isolated for histological detection of apoptosis by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assay. RESULTS: In the in vitro tests, fluorescence intensity was low for healthy cells and high for apoptotic cells when incubated with FITC-labeled annexin A5 and A5MB. Rats treated with doxorubicin showed significant contrast opacification of the myocardium on contrast echocardiography using A5MB. However, no opacification was observed in control rats. Apoptosis was confirmed by TUNEL assay in doxorubicin treated rats. CONCLUSION: Acute doxorubicin-induced cardiomyopathy based on early apoptosis can be assessed and imaged with targeted ultrasound imaging using A5MB in rats.
Adult ; Animals ; Annexin A5 ; Aorta ; Apoptosis ; Avidin ; Cardiomyopathies ; Doxorubicin ; Echocardiography ; Flow Cytometry ; Fluorescein-5-isothiocyanate ; Fluorescence ; Heart ; Humans ; Hydrogen Peroxide ; In Situ Nick-End Labeling ; Male ; Microbubbles ; Myocardium ; Myocytes, Smooth Muscle ; Rats